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NPI Code Detail

MEDICARE: AMERICAN FAMILY MEDICINE LLC

MEDICARE: AMERICAN FAMILY MEDICINE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician
2207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1477908085
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN FAMILY MEDICINE LLC
Provider Business Mailing Address
First Line : 1514 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-6101
Country : US
Telephone Number : 602-283-5732
Fax Number : 602-314-4579
Provider Business Practice Location Address
First Line : 1514 W THOMAS RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-6101
Country : US
Telephone Number : 602-283-5732
Fax Number : 602-314-4579
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : ALEJANDRO E LOPEZ
Credential : MD
Telephone Number : 602-283-5732
Provider Enumeration Date : 05/02/2016
Last Update Date : 07/21/2022

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Directions to “AMERICAN FAMILY MEDICINE LLC ” Practice Location

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